Abstract
Deaths after ingestion of hydrogen peroxide (HP) are very rare, but poisoning due to consumption of HP is not uncommon. Most HP exposure involves common household-strength (3 %) HP and is usually benign. Even if it is not generally considered to be a poison, it can cause accidental death. HP results in morbidity through two main mechanisms: direct cytotoxic injury to tissues and formation of oxygen gas. We describe a rare case of a 2-year-old female who died after accidentally ingesting two sips of 35 % HP. For the first time, we provide histopathological images of the damage caused by HP in organic tissues.
References
Watt BE, Proudfoot AT, Vale JA. Hydrogen peroxide poisoning. Toxicol Rev. 2004;23:51–7.
Neidich G. Ingestion of caustic alkali farm products. J Pediatr Gastroenterol Nutr. 1993;1:75–7.
Burns RA, Schmidt SM. Portal venous gas emboli after accidental ingestion of concentrated HP. J Emerg Med. 2013;45:345–7.
Wax P. Antiseptics, disinfectants and sterilants. In: Goldfrank L, editor. Goldfrank’s toxicologic emergencies. 8th ed. New York: McGraw-Hill Companies; 2006. p. 1384–97.
Humberston CL, Dean BS, Krenzelok EP. Ingestion of 35 % hydrogen peroxide. J Toxicol Clin Toxicol. 1990;28:95–100.
Mullins ME, Beltran JT. Acute cerebral gas embolism from hydrogen peroxide ingestion successfully treated with hyperbaric oxygen. J Toxicol Clin Toxicol. 1998;36:253–6.
Zengin S, Al B, Genç S, Yarbil P, Yilmaz DA, Gulsen MT. A rare case of portal vein gas: accidental hydrogen peroxide ingestion. BMJ Case Rep. 2012.
Islamoglu Y, Cil H, Atilgan Z, Elbey MA, Tekbas E, Yazici M. Myocardial infarction secondary to unintentional ingestion of hydrogen peroxide. Cardiol J. 2012;19:86–8.
Dickson KF, Caravati EM. Hydrogen peroxide exposure—325 exposures reported to a regional poison control center. J Toxicol Clin Toxicol. 1994;32:705–14.
Pritchett S, Green D, Rossos P. Accidental ingestion of 35 % hydrogen peroxide. Can J Gastroenterol. 2007;21:665–7.
Sherman SJ, Boyer LV, Sibley WA. Cerebral infarction immediately after ingestion of hydrogen peroxide solution. Stroke. 1994;25:1065–7.
Henry MC, Wheeler J, Mofenson HC, Caraccio TR, Marsh M, Comer GM, Singer AJ. Hydrogen peroxide 3 % exposures. J Toxicol Clin Toxicol. 1996;34:323–7.
Moon JM, Chun BJ, Minn YI. Hemorrhagic gastritis and gas emboli after ingesting 3 % hydrogen peroxide. J Emerg Med. 2006;30:403–6.
Rackoff WR, Merton DF. Gas embolism after ingestion of hydrogen peroxide. Pediatrics. 1990;85:593–4.
Cina SJ, Downs JC, Conradi SE. Hydrogen peroxide: a source of lethal oxygen embolism. Case report and review of the literature. Am J Forensic Med Pathol. 1994;15:44–50.
Mofenson H, Caraccio T, Wheeler J. Toxicity of 3 % hydrogen peroxide (H2O2) otc. J Toxicol Clin Toxicol. 1995;33:488.
Ashdown BC, Stricof DD, May ML, Sherman SJ, Carmody RF. Hydrogen peroxide poisoning causing brain infarction: neuroimaging findings. AJR Am J Roentgenol. 1998;170:1653–5.
Christensen DW, Faught WE, Black RE, Woodward GA, Timmons OD. Fatal oxygen embolization after hydrogen peroxide ingestion. Crit Care Med. 1992;20:543–4.
Rider SP, Jackson SB, Rusyniak DE. Cerebral air gas embolism from concentrated hydrogen peroxide ingestion. Clin Toxicol. 2008;46:815–8.
Ghai S, Martin E. Portal vein gas resulting from ingestion of hydrogen peroxide. AJR. 2003;181:1719–20.
Bollen P, Goossens A, Hauser B, et al. Colonic ulcerations caused by an enema containing hydrogen peroxide. J Pediatr Gastroent Nutr. 1998;26:232–3.
Ijichi T, Itoh T, Sakai R, et al. Multiple brain gas emboli after ingestion of concentrated hydrogen peroxide. Neurology. 1997;48:277–9.
Gannon G, Caravati EM, Filloux FM. Hydrogen peroxide neurotoxicity in childhood: Case report with unique magnetic resonance imaging features. J Child Neurol. 2003;18:805–8.
Ikiz MA, Yakut HI, Kurt F, et al. HP solution ingestion caused brain death of a 3-year-old girl. Pediatr Emerg Care. 2013;29:502–3.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Indorato, F., Raffino, C., Tropea, F.M. et al. Fatal accidental ingestion of 35 % hydrogen peroxide by a 2-year-old female: case report and literature review. Forensic Sci Med Pathol 10, 443–447 (2014). https://doi.org/10.1007/s12024-014-9560-9
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12024-014-9560-9